Provider Demographics
NPI:1346516176
Name:MICHEL, DANICA LEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANICA
Middle Name:LEE
Last Name:MICHEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 BROAD ST # 203
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3006
Mailing Address - Country:US
Mailing Address - Phone:727-220-0134
Mailing Address - Fax:727-873-7869
Practice Address - Street 1:10810 US HIGHWAY 19 N # A
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-7441
Practice Address - Country:US
Practice Address - Phone:727-220-0134
Practice Address - Fax:727-873-7869
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist